Dialectical Behavior Therapy: An Overview of the Treatment 3 WHO THIS BOOK IS FOR There are two intended audiences for The Dialectical Behavior Therapy Skills Workbook. The first is people who are in dialectical behavior therapy (either group or individual) and need a workbook to help learn the four key skills. Training as a DBT therapist is training to save and change lives. It is not for the faint-hearted, AND it is life-changing for both client and therapist. In these ten short videos, journey through the world of DBT and find out if becoming a DBT therapist is right for you.
By Zainab Fazal, M.ADS, BCBA
bSci21 Contributing Writer
On June 22, 2015, I received a phone call from a staff at a local residential home serving adults with developmental disabilities. With a lot of excitement, she asked if I watched NBC Dateline the night before. Before I could answer, in even more excitement, she said, 'that guy did that strategy you were talking about in class!'
Let me give you a little insight into what she was talking about. She was referring to the segment on NBC Dateline called 'My kid would never do that: gun safety', and the guy was Dr. Raymond Miltenberger.You can check out the segment here.
If you teach anyone, anything, behavior analysis has a secret to share with you. It's the strategy the staff was talking about – Behavior Skills Training (BST). It is a method to teach students, staff, parents, and anyone else you are teaching a new skill. Dr. Miltenberger defines BST as 'a procedure consisting of instruction, modeling, behavioral rehearsal, and feedback that is used to teach new behaviors or skills' (2004, p. 558). And that's exactly what it is, a 4-step teaching strategy that works!
BST teaches a person what to do — that is, what behaviors to engage in under a particular circumstance.It allows for practice within the program so that the person can become fluent with the skills.It is an effective train-the-trainer procedure. And perhaps most importantly, can be individualized to each person. Sounds pretty good, doesn't it?
Let's break down each of the steps:
Instruction – Provide a description of the skill, its importance or rationale, and when and when not to use the skill. Repeat this step as necessary.
Modeling – Show your participant how to perform the skill. In-vivo modeling is recommended.
Rehearsal – Practice, practice, and practice! Allow the participant opportunities to practice the skill. Recent research suggests that participants should be able to practice in-situ. The trainer should record data on correct and incorrect responding during this step.
Feedback – The trainer should provide positive praise for correct responding and some form of corrective feedback for incorrect responses.
Some requirements before you can implement a BST program include: the person receiving the training must have the pre-requisite skills required for the behaviors you are teaching, the skill must include a chain of behaviors (a number of skills), and you must be able to role-play or video model the skills.
Training Courses Dialectical Behavior Therapy
In a Registered Behavior Technician training course I was providing, I used BST to teach various skills to participants. Any skill I was teaching that met the afore-mentioned requirements I taught using BST. Based on the feedback forms from eight cohorts, participants reported that they enjoyed and learned the most when they got to practice the skills being taught, and got immediate feedback.
Here's an example of how it was used in the training. The skill was implementing preference assessments with clients.
Instructions were provided on why preference assessments are done, when and with whom to do them, how to use the data sheet, the materials required, and how to complete the assessment.
I modeled completing a preference assessment, using one of the course participants as my 'client.'
Participants paired up and practiced administering the preference assessment with their colleagues.Participants were able to practice the skill as each preference assessment included 30 trials!
I went to each group and provided feedback on what each person was doing correctly and incorrectly.
What have been your experiences with Behavior Skills Training? Let us know in the comments below. Also, be sure to subscribe to bSci21 via email to receive the latest articles directly to your inbox!
Recommended Readings:
Johnson, B.M., Miltenberger, R.G., Egemo-Helm, K., Jostad, C. J., Flessner, C., & Gatheridge, B. (2005). Evaluation of behavioural skills training for teaching abduction-prevention skills to young children. Journal of Applied Behavior Analysis, 38, 67-78.
Miles, N.I., & Wilder, D.A. (2009). The effects of behavioral skills trainingon caregiver implementation of guided compliance. Journal of Applied Behavior Analysis, 42(2), 405-410.
Miltenberger, R. (2004). Behaviour Modification: principals and procedure (3rd ed.) Belmont, CA. Wadsworth Publishing.
Miltenberger, R.G., Flessner, C., Batheridge, B., Johnson, B., Satterlund, M., & Egemo, K. (2004). Evaluation of behavioural skills training procedures to prevent gun play in children. Journal of Applied Behavior Analysis, 37, 513-516.
Steward, K.K., Carr, J.E., & LeBlanc, L.A. (2007). Evaluation of family-implemented behavioural skills training for teaching social skills to a child with asperger's disorder. Clinical Case Studies, 6, 252-262.
Zainab Fazal, M.ADS, BCBA, began her career in the developmental disabilities field in 2002, and has dedicated her clinical work and research in the area of Applied Behaviour Analysis (ABA). She has worked for many years in assessing and developing comprehensive programs plans for children, youth, and adults with Autism Spectrum Disorders (ASD), learning disabilities, other developmental disabilities, behavioural challenges and mental health issues. Her recent work includes training front-line staff and teachers to use ABA in therapeutic and school settings, and has successfully trained individuals for the Registered Behaviour Technician credential with the Behaviour Analyst Certification Board. She is also an adjunct professor at Seneca College teaching ABA courses in the Behavioural Sciences program. Zainab is the founder and director of Phoenix Behaviour Services, a private practice in Toronto, Canada. You can follow her on twitter @Phoenix_ABA and reach her at zainab@pbxs.ca.
To continue with your registration, you will be taken to the
PESI Rehab website.
You may purchase using your existing PESI account.
If you do not currently have a PESI account, you can create one during checkout.
- Where:
- SEATTLE, WA
- When:
- Wednesday, November 13, 2019 - Friday, November 15, 2019
This event is not currently available for purchase.
For more information: Call (800) 844-8260
Dialectical Behavior Therapy is a powerful, evidence-based treatment that allows clinicians to provide positive outcomes for clients of all ages struggling with stress, depression, trauma, suicidal and self-destructive behaviors and a variety of other clinical presentations.
This 3-day Certification Training will build the core competencies you need to bring DBT into your clinical practice and effectively use it with a wide range of client types. In just 3 days you'll be given a roadmap to treat individuals using the skills and techniques from DBT so you can help your most challenging clients reach new levels of healing.
Even if you've attended other Dialectical Behavior Therapy (DBT) trainings, this program will increase your competency and clinical sophistication with DBT when working with adults, youth, substance users and trauma survivors in a wide variety of settings.
Better still, you'll not only leave this event with a powerful treatment approach, you'll also have fulfilled the education requirements should you choose to pursue Certification in Dialectical Behavior Therapy through evergreen Certification Institute (visit evgci.com for details).
Sign up today and get the skills and confidence you need to successfully help your clients with the power of DBT!
Katelyn Baxter-Musser, LCSW, is not affiliated or associated with Marsha M. Linehan, PhD, ABPP, or her organizations.
- Explore the origins of Biosocial Theory and communicate the clinical implications of the theory.
- Specify how DBT skills can help clients identify unhealthy interaction styles.
- Characterize how mindfulness skills can empower clients to interpret situations in new ways and react in healthier ways.
- Communicate how clinicians can effectively teach DBT skills and encourage support and constructive feedback in a group setting.
- Establish ways in which clinicians can maximize client buy-in for DBT homework assignments.
- Determine how interpersonal skills training can be used with clients to improve relationships.
- Specify how DBT skills can be used to decrease the likelihood of compassion fatigue in clinicians.
- Characterize how DBT skills can be utilized to identify and overcome obstacles to changing emotions and reactive behaviors.
- Communicate ways in which DBT can be adapted for working with children and adolescents.
- Provide a brief explanation of how DBT can be used in working with trauma survivors.
- Establish how diary cards can be used by clients to monitor their emotions and track how they are using DBT skills to deal with challenges.
- Specify how a chain analysis can be effectively utilized with clients to help them gain insight into how they can change problem behaviors.
- Determine how opposite action strategies can be used by clients to reduce self-destructive urges.
- Support how interpersonal effectiveness exercises can be employed in therapy to help clients keep relationship without sacrificing their self-respect.
- Establish how a pros and cons list can help clients see the consequences of their actions and make better choices when they are faced with a difficult decision.
- Communicate strategies to confront therapy interfering behaviors and help clients overcome avoidance.
- Articulate how Dialectical Behavior Therapy interventions can help clients foster radical acceptance of traumatic events and reduce feelings of shame, guilt and fear.
- Specify how the STOP skills can help clients to manage crisis situations and prevent them from doing something impulsive they might regret later.
- Determine how clinicians can use the levels of validation to enhance the therapeutic alliance and teach clients to validate themselves.
- Establish how DBT skills can be used with clients to reduce self-harm and suicidal behaviors.
- Characterize how clinicians can help develop a client's Wise Mind state so they can be more aware of less impulsive in their actions.
Foundations of DBT
- Biosocial Theory
- Characteristics of DBT
- DBT as an evidence-based practice
- Dialectics: the balance of acceptance and change
- Application of DBT in the individual and group therapy setting
- Skills training methods
- Validation strategies
- Research and limitations
Mindfulness: Cultivate the Skills at the Core of Successful DBT Therapy
- Acceptance vs. judgement
- Wise mind – achieve harmony between emotion and reason
- Accessible exercises for building mindfulness skills
- Observation – keep clients calm, centered and aware
- Describe – overcome assumptions
- Participation – release judgement and fear
- Strategies for teaching mindfully and exercises for therapy
- Tools to identify strengths
- Balancing relationships with self-respect
- Exercises and role play guidance on how to:
- Develop healthy assertiveness skills
- Enhance conflict resolution skills
- Build empathy
- Keep problems from building up
- Resist pressure
- Top strategies for changing behavior
- Strong emotions and poor coping skills
- How to change unwanted emotions
- Reduce emotional vulnerability while practicing self-care
- Opposite action skills to reduce maladaptive behavior
- Emotion Regulation exercises
- Self-soothing strategies that work
- Learn the sleep hygiene protocol
Let's break down each of the steps:
Instruction – Provide a description of the skill, its importance or rationale, and when and when not to use the skill. Repeat this step as necessary.
Modeling – Show your participant how to perform the skill. In-vivo modeling is recommended.
Rehearsal – Practice, practice, and practice! Allow the participant opportunities to practice the skill. Recent research suggests that participants should be able to practice in-situ. The trainer should record data on correct and incorrect responding during this step.
Feedback – The trainer should provide positive praise for correct responding and some form of corrective feedback for incorrect responses.
Some requirements before you can implement a BST program include: the person receiving the training must have the pre-requisite skills required for the behaviors you are teaching, the skill must include a chain of behaviors (a number of skills), and you must be able to role-play or video model the skills.
Training Courses Dialectical Behavior Therapy
In a Registered Behavior Technician training course I was providing, I used BST to teach various skills to participants. Any skill I was teaching that met the afore-mentioned requirements I taught using BST. Based on the feedback forms from eight cohorts, participants reported that they enjoyed and learned the most when they got to practice the skills being taught, and got immediate feedback.
Here's an example of how it was used in the training. The skill was implementing preference assessments with clients.
Instructions were provided on why preference assessments are done, when and with whom to do them, how to use the data sheet, the materials required, and how to complete the assessment.
I modeled completing a preference assessment, using one of the course participants as my 'client.'
Participants paired up and practiced administering the preference assessment with their colleagues.Participants were able to practice the skill as each preference assessment included 30 trials!
I went to each group and provided feedback on what each person was doing correctly and incorrectly.
What have been your experiences with Behavior Skills Training? Let us know in the comments below. Also, be sure to subscribe to bSci21 via email to receive the latest articles directly to your inbox!
Recommended Readings:
Johnson, B.M., Miltenberger, R.G., Egemo-Helm, K., Jostad, C. J., Flessner, C., & Gatheridge, B. (2005). Evaluation of behavioural skills training for teaching abduction-prevention skills to young children. Journal of Applied Behavior Analysis, 38, 67-78.
Miles, N.I., & Wilder, D.A. (2009). The effects of behavioral skills trainingon caregiver implementation of guided compliance. Journal of Applied Behavior Analysis, 42(2), 405-410.
Miltenberger, R. (2004). Behaviour Modification: principals and procedure (3rd ed.) Belmont, CA. Wadsworth Publishing.
Miltenberger, R.G., Flessner, C., Batheridge, B., Johnson, B., Satterlund, M., & Egemo, K. (2004). Evaluation of behavioural skills training procedures to prevent gun play in children. Journal of Applied Behavior Analysis, 37, 513-516.
Steward, K.K., Carr, J.E., & LeBlanc, L.A. (2007). Evaluation of family-implemented behavioural skills training for teaching social skills to a child with asperger's disorder. Clinical Case Studies, 6, 252-262.
Zainab Fazal, M.ADS, BCBA, began her career in the developmental disabilities field in 2002, and has dedicated her clinical work and research in the area of Applied Behaviour Analysis (ABA). She has worked for many years in assessing and developing comprehensive programs plans for children, youth, and adults with Autism Spectrum Disorders (ASD), learning disabilities, other developmental disabilities, behavioural challenges and mental health issues. Her recent work includes training front-line staff and teachers to use ABA in therapeutic and school settings, and has successfully trained individuals for the Registered Behaviour Technician credential with the Behaviour Analyst Certification Board. She is also an adjunct professor at Seneca College teaching ABA courses in the Behavioural Sciences program. Zainab is the founder and director of Phoenix Behaviour Services, a private practice in Toronto, Canada. You can follow her on twitter @Phoenix_ABA and reach her at zainab@pbxs.ca.
To continue with your registration, you will be taken to the
PESI Rehab website.
You may purchase using your existing PESI account.
If you do not currently have a PESI account, you can create one during checkout.
- Where:
- SEATTLE, WA
- When:
- Wednesday, November 13, 2019 - Friday, November 15, 2019
This event is not currently available for purchase.
For more information: Call (800) 844-8260
Dialectical Behavior Therapy is a powerful, evidence-based treatment that allows clinicians to provide positive outcomes for clients of all ages struggling with stress, depression, trauma, suicidal and self-destructive behaviors and a variety of other clinical presentations.
This 3-day Certification Training will build the core competencies you need to bring DBT into your clinical practice and effectively use it with a wide range of client types. In just 3 days you'll be given a roadmap to treat individuals using the skills and techniques from DBT so you can help your most challenging clients reach new levels of healing.
Even if you've attended other Dialectical Behavior Therapy (DBT) trainings, this program will increase your competency and clinical sophistication with DBT when working with adults, youth, substance users and trauma survivors in a wide variety of settings.
Better still, you'll not only leave this event with a powerful treatment approach, you'll also have fulfilled the education requirements should you choose to pursue Certification in Dialectical Behavior Therapy through evergreen Certification Institute (visit evgci.com for details).
Sign up today and get the skills and confidence you need to successfully help your clients with the power of DBT!
Katelyn Baxter-Musser, LCSW, is not affiliated or associated with Marsha M. Linehan, PhD, ABPP, or her organizations.
- Explore the origins of Biosocial Theory and communicate the clinical implications of the theory.
- Specify how DBT skills can help clients identify unhealthy interaction styles.
- Characterize how mindfulness skills can empower clients to interpret situations in new ways and react in healthier ways.
- Communicate how clinicians can effectively teach DBT skills and encourage support and constructive feedback in a group setting.
- Establish ways in which clinicians can maximize client buy-in for DBT homework assignments.
- Determine how interpersonal skills training can be used with clients to improve relationships.
- Specify how DBT skills can be used to decrease the likelihood of compassion fatigue in clinicians.
- Characterize how DBT skills can be utilized to identify and overcome obstacles to changing emotions and reactive behaviors.
- Communicate ways in which DBT can be adapted for working with children and adolescents.
- Provide a brief explanation of how DBT can be used in working with trauma survivors.
- Establish how diary cards can be used by clients to monitor their emotions and track how they are using DBT skills to deal with challenges.
- Specify how a chain analysis can be effectively utilized with clients to help them gain insight into how they can change problem behaviors.
- Determine how opposite action strategies can be used by clients to reduce self-destructive urges.
- Support how interpersonal effectiveness exercises can be employed in therapy to help clients keep relationship without sacrificing their self-respect.
- Establish how a pros and cons list can help clients see the consequences of their actions and make better choices when they are faced with a difficult decision.
- Communicate strategies to confront therapy interfering behaviors and help clients overcome avoidance.
- Articulate how Dialectical Behavior Therapy interventions can help clients foster radical acceptance of traumatic events and reduce feelings of shame, guilt and fear.
- Specify how the STOP skills can help clients to manage crisis situations and prevent them from doing something impulsive they might regret later.
- Determine how clinicians can use the levels of validation to enhance the therapeutic alliance and teach clients to validate themselves.
- Establish how DBT skills can be used with clients to reduce self-harm and suicidal behaviors.
- Characterize how clinicians can help develop a client's Wise Mind state so they can be more aware of less impulsive in their actions.
Foundations of DBT
- Biosocial Theory
- Characteristics of DBT
- DBT as an evidence-based practice
- Dialectics: the balance of acceptance and change
- Application of DBT in the individual and group therapy setting
- Skills training methods
- Validation strategies
- Research and limitations
Mindfulness: Cultivate the Skills at the Core of Successful DBT Therapy
- Acceptance vs. judgement
- Wise mind – achieve harmony between emotion and reason
- Accessible exercises for building mindfulness skills
- Observation – keep clients calm, centered and aware
- Describe – overcome assumptions
- Participation – release judgement and fear
- Strategies for teaching mindfully and exercises for therapy
- Tools to identify strengths
- Balancing relationships with self-respect
- Exercises and role play guidance on how to:
- Develop healthy assertiveness skills
- Enhance conflict resolution skills
- Build empathy
- Keep problems from building up
- Resist pressure
- Top strategies for changing behavior
- Strong emotions and poor coping skills
- How to change unwanted emotions
- Reduce emotional vulnerability while practicing self-care
- Opposite action skills to reduce maladaptive behavior
- Emotion Regulation exercises
- Self-soothing strategies that work
- Learn the sleep hygiene protocol
- Developing crisis survival and reality acceptance skills
- 4 options to solving problems
- Problem solving case studies
- Using pros and cons to make decisions
- STOP skills to manage crisis situations
- The steps to practicing radical acceptance
- Tools to accept change
- Analyzing behaviors; chain analysis & missing links analysis
- Diary cards and homework with clients
- Identify therapy interfering behaviors
- Develop skills to identify and manage self-harming & suicidal behaviors
- Screening and assessment tools for self-harming behaviors
- Interventions and treatment considerations for the self-harming population
- Suicide risk as a skills deficit problem
- Tools and techniques to assess for level of risk
- Firearms, medications, and lethal-means restriction plans that work
- Safety plans and crisis intervention
4 Pdfdialectical Behavioral Training Seminars
- Children and adolescents
- Trauma survivors
- Substance abusers
- 3 ways to decrease therapist burnout
- The characteristics of an effective DBT team
- Integrating DBT into your practice
- Counselors
- Psychologists
- Psychotherapists
- Social Workers
- Marriage & Family Therapists
- Addiction Counselors
- Case Managers
- Mental Health Professionals
- Nurses
KATELYN BAXTER-MUSSER, LCSW, CDBT
Dialectical Behavioral Therapy Definition
Ms. Baxter-Musser is trained in DBT and incorporates it into her practice in working with adolescents and adults presenting with a variety of concerns. She has facilitated DBT skill groups and has used DBT in individual therapy in private practice and in work for several agencies. Her years of experience using DBT principles in her practice have helped her clients to develop healthier coping skills, better process their past traumas, and increase their ability to identify and cope with destructive emotions.
Ms. Baxter-Musser is also trained in Cognitive Behavioral Therapy and is a certified EMDR therapist. She is a member of the National Association of Social Workers, the American Academy of Experts in Traumatic Stress, the National Center for Crisis Management and the Maine Collaborative law Alliance. She sits on the EMDRIA Standards and Training Committee and is the co-regional coordinator for the EMDRIA Southern Maine Regional Network. She works in private practice where her areas of expertise include the treatment of trauma, PTSD, depression, anxiety, grief and relationship issues.
Speaker Disclosures:
Financial: Katelyn Baxter-Musser maintains a private practice. She receives a speaking honorarium from PESI, Inc.
Non-financial: Katelyn Baxter-Musser is a member of the National Association of Social Workers.
- Psychotherapy Networker Magazine Subscription - 1 Year (Full Price $36.00) - $12.99
- The DBT Deck for Clients and Therapists: 101 Mindful Practices to Manage Distress, Regulate Emotions & Build Better Relationships - $19.99
- The Expanded Dialectical Behavior Therapy Skills Training Manual, DBT for Self-Help and Individual & Group Treatment Settings, 2nd Edition - $34.99
- You Untangled: Practical Tools to Manage Your Emotions and Improve Your Life - $24.99
If your profession is not listed, please contact your licensing board to determine your continuing education requirements and check for reciprocal approval. For other credit inquiries not specified below, or questions on home study credit availability, please contact cepesi@pesi.com or 800-844-8260 before the event.
Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of mental health professionals. As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice in accordance with and in compliance with your professions standards.
The planning committee and staff who controlled the content of this activity have no relevant financial relationships to disclose. For speaker disclosures, please see speaker bios.
PESI, Inc. offers continuing education programs and products under the brand names PESI, PESI Healthcare, PESI Rehab and Psychotherapy Networker.
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This course has been approved by PESI, Inc., as a NAADAC Approved Education Provider, for 21.0 CE in the Counseling Services skill group. NAADAC Provider #77553. PESI, Inc. is responsible for all aspects of their programming. Full attendance is required; no partial credit will be awarded for partial attendance.
Counselors
This intermediate activity consists of 21.0 clock hours of continuing education instruction. Credit requirements and approvals vary per state board regulations. Please save the course outline, the certificate of completion you receive from the activity and contact your state board or organization to determine specific filing requirements.
Washington Counselors: CE credit is available. This training has been approved for 21.0 CE's for Washington Licensed Mental Health Counselors, Licensed Marriage and Family Therapists and Licensed Clinical Social Workers. WMHCA Provider #1504.
Marriage & Family Therapists
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Washington Marriage & Family Therapists: This training has been approved for 21.0 CE's for Washington Licensed Mental Health Counselors, Licensed Marriage and Family Therapists and Licensed Clinical Social Workers. WMHCA Provider #1504.
Nurses, Nurse Practitioners, and Clinical Nurse Specialists
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Psychologists & Physicians
Physicians
PESI, Inc. is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. PESI, Inc. designates this live activity for a maximum of 19.0 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Psychologists
The following state psychologist boards recognize activities sponsored by PESI, Inc. as an approved ACCME provider: Alaska, Arkansas, California, Colorado, Georgia, Illinois, Indiana, Kentucky, Maine, Maryland, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, Oklahoma, Pennsylvania, South Carolina and Wisconsin. This activity consists of 19.0 clock hours of continuing education instruction. Certificates of attendance will be issued for you to submit to your state licensing board to recognize for continuing education credit.
Psychologists
This live activity consists of 21.0 clock hours of continuing education instruction. Credit requirements and approvals vary per state board regulations. Please save the course outline and the certificate of completion you receive from this live activity. Contact us for more information on your state board or organization specific filing requirements. American Psychological Association credits are not available.
California Psychologists: CE credit is available. PESI, Inc. is approved by the California Psychological Association to provide continuing education for psychologists. Provider #PES010. PESI maintains responsibility for this program and its contents. PESI is offering this activity for 21.0 hours of continuing education credit. Full attendance is required; no partial credits will be offered for partial attendance.
Social Workers
PESI, Inc., #1062, is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved as ACE providers. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. PESI, Inc. maintains responsibility for this course. ACE provider approval period: January 27, 2020 - January 27, 2023. Social Workers completing this course receive 21.0 Clinical Practice continuing education credits. Course Level: Intermediate. Full attendance is required; no partial credits will be offered for partial attendance. A certificate of attendance will be awarded at the end of the program to social workers who complete the program evaluation.
Washington Social Workers: This training has been approved for 21.0 CE's for Washington Licensed Mental Health Counselors, Licensed Marriage and Family Therapists and Licensed Clinical Social Workers. WMHCA Provider #1504.
Other Professions
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